Health literacy and its socio-demographic risk factors in Hebei: A cross-sectional survey

This study aimed to evaluate the prevalence of low health literacy in Hebei Province of China, and to investigate its socio-demographic risk factors.This study was a community-based, cross-sectional questionnaire survey with a multiple-stage randomization design and a sample size of 10,560. Participants’ health literacy status was evaluated by a questionnaire based on the 2012 Chinese Resident Health Literacy Scale. Meanwhile, participants’ socio-demographic characteristics were also collected by the questionnaire.A total of 9952 participants provided valid questionnaires and were included in the final analyses. The mean health literacy score was 63.1 ± 17.1 points; for its subscales, the mean basic knowledge and concepts score, lifestyle score, health-related skills score were 31.7 ± 9.0, 17.2 ± 4.8, 14.3 ± 4.1, respectively. Meanwhile, low health literacy prevalence was 81.0%; for its subscales, low basic knowledge and concepts prevalence (70.6%) was numerically reduced compared to low lifestyle prevalence (87.4%) and low health-related skills prevalence (86.1%). Further analyses showed that age, male, and rural area were positively associated, but education level and annual household income were negatively associated with low health literacy prevalence. Further multivariate logistic regression analyses showed that higher age, male, lower education level, lower annual household income, and rural area were closely correlated with the risks of low total health literacy or low health literacy in subscales in Hebei Province.The prevalence of low health literacy is 81.0% in Hebei Province. Meanwhile, higher age, male, lower education level, lower annual household income, and rural area closely associate with low health literacy risk.     

缺血性脑卒中患者健康素养及影响因素的研究

目的了解缺血性脑卒中患者健康素养现状及影响因素,为预防和改善缺血性脑卒中患者预后开展健康促进工作提供科学依据。方法采用便利抽样法选取两所医院200例缺血性脑卒中住院患者进行健康素养问卷调查。结果①研究对象健康素养总均分(139.32±36.21)分,处于临界水平。②年龄、文化程度、婚姻状态是缺血性脑卒中患者健康素养的影响因素。结论缺血性脑卒中患者健康素养处于临界水平,且受年龄、文化程度、婚姻状态因素的影响,提升健康素养有利于提高脑卒中二级预防的防治水平,从而改善缺血性脑卒中患者的健康结局。     

Health literacy of college freshmen in jiangsu,China: A 3-year longitudinal survey

Health literacy (HL) has become an important public health issue and received growing attention in recent years. However, knowledge about the HL of adolescents and young adults is limited.^[1] This study aimed to investigate the awareness rate of HL and its related factors among college freshmen in Jiangsu, China. And the results were used to support the promotion intervention to improve the HL of at-risk groups among this population.A total of 25,272 freshmen were surveyed through multi-stage stratified random sampling from 20 colleges and universities in Jiangsu province between 2016 to 2018. Data were obtained using the “Chinese Citizen Health Literacy Questionnaire” (2013 edition). Multiple logistic regression analysis was conducted to determine the factors influencing HL levels.The awareness rate of HL of college freshmen in Jiangsu province was 26.6% among the 25,272 subjects. The awareness rate of HL tended to increase from 2016 to 2018, which was 17.9%, 21.5%, and 39.6%, respectively (P < 0.001). Specifically, except for chronic diseases, knowledge and attitudes, knowledge and attitudes toward health-related behavior and lifestyle, health-related skill and scientific views of health, infection diseases, safety and first aid, medical care, health information awareness rate all have improved to a certain degree (P < .001). The independent factors associated with HL awareness rate were sex (odds ratio [OR] = 1.099, (1.039 –1.164)), residence (urban: OR = 1.141, (1.056∼1.234)), educational system (OR = 2.133, (1.975–2.305)), only child or not (OR = 1.087, (1.018–1.161)), family structure (OR = 1.192, (1.078–1.319)) and maternal education level (high school: OR = 1.183 (1.067–1.313); university and more: OR = 1.481 (1.324–1.658)).Awareness rate of HL of college freshmen is associated with multi-complex factors, further works are recommended to improve the HL levels of college freshmen, especially for the aspect of chronic diseases.     

E-health literacy of nursing students and investigation of factors affecting e-health literacy during COVID-19 pandemic process: A cross-sectional study

The lack of knowledge on health literacy affects all segments of society, particularly health workers.The objectives were to identify nursing students’ means of accessing information during the coronavirus disease 2019 pandemic, their level of health literacy, and the factors that affect it.This cross-sectional study was conducted in Turkey among 398 nursing students of Çukurova University and Van Yüzüncü Yil University between June 1 and June 30, 2020. As a data collection tool, E-Health Literacy Scale was used, with students’ characteristics and personal information form related to Internet use. These forms were converted to the online format. The survey link was sent to the students’ smartphones and/or e-mails to ask them to participate.Majority of participants were Van Yüzüncü Yil University nursing students (63.8%). E-SYO score average of all students was found to be 29.42 ± 4.39 (min = 14, max = 40); it was is found be at a good level. They used the Internet as the first source of information about coronavirus disease 2019 (65.1%).Among the participants, 65.8% stated that it was important to access the health resource on the Internet and 19.1% of the participants thought that it was very important. It was found that Internet use was being used for >3 times a day (72.9%). The age, class, gender, family type, income level, high school from which they graduated from, and their working status significantly were statistically affecting their health literacy (P < .05). The health literacy scale scores were significant and higher than those who did not know the concept of health literacy, and those who perceived Internet skills well and very well than those who perceived them poorly (P < .05).Nursing students were found to have good average health literacy averages. Improving the health literacy is important for making individuals healthier.     

高龄骨性关节炎患者的健康素养现况及相关影响因素

目的 分析高龄骨性关节炎患者的健康素养现况及相关影响因素分析。方法 借助便利性抽样调研法,将2022年6月至12月于海口市人民医院就诊的90例高龄骨性关节炎患者做为观察对象。收集患者的一般资料,采用慢性病健康素养问卷对骨性关节炎高龄患者的健康素养进行量化评价。采用SPSS 22.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、方差分析及χ²检验。采用多元线性回归分析影响高龄骨性关节炎患者健康素养的相关因素。结果 本研究共发放90份问卷,回收有效问卷82份。82例高龄骨性关节炎患者健康素养量表总分为(93.0±6.7)分,其中信息沟通维度的条目均分最高(4.5±1.1)分,获取信息能力维度的条目均分最低(3.4±1.2)分。不同性别、学历层次、婚姻情况、居留地、家庭人均月收入、疾病持续时间、患者健康素养得分比较,差异有统计学意义(P<0.05)。多元线性回归分析提示,性别(β=-0.153;P=0.014)、婚姻情况(β=-0.179;P=0.006)、受教育水平(β=0.438;P<0.001)、疾病持续时间(β=-0.018;P=0.002...     

Morbidity and associated factors in rural and urban populations of South Lebanon: a cross-sectional community-based study of self-reported health in 2000

OBJECTIVE: To assess self-reported morbidity and its determining factors in South Lebanon, with an emphasis on the influence of the habitat location (urban vs. rural) and gender. METHODS: Cross-sectional survey in 2000 among 524 South Lebanon residents >/=14 years sampled from a random sample of households using a multi-level cluster sampling technique. Data on self-reported morbidity, lifestyle and socioeconomic status were collected through interviews, using a standardized questionnaire. To evaluate deprivation, a new index was created; the modified 'Living Conditions Index'. Stepwise logistic regression analysis was performed to test the effect of habitat and gender on self-reported morbidity. RESULTS: People in one-fifth of the households lived in precarious conditions. Illiteracy was significantly higher in rural than urban settings. Urban residents reported obesity, varicose veins, anxiety/depression and visual disorders more often. Illiteracy, headaches, lumbar pain, varicose veins and anxiety/depression were more frequently reported by women, whereas ulcers, hearing disorders, cardio-vascular diseases and their risk factors were more frequently reported by men. Precarious living conditions were associated with headaches, lumbar pains and insomnia. Individuals covered by a health insurance sought care more often than the uninsured. CONCLUSION: Habitat location had only a minor influence on self-reported morbidity; women perceived their health as poorer than men and a number of disease conditions were influenced by deprivation. Our study confirms that the epidemiological transition phenomenon had occurred in South Lebanon in 2000. Our community-based data can serve as a baseline for monitoring changes in health in South Lebanon in the future and especially those because of the war that emerged in July 2006.     

Brief report: Resident recognition of low literacy as a risk factor in hospital readmission

BACKGROUND: Low literacy is associated with poor self-management of disease and increased hospitalization, yet few studies have explored the extent to which physicians consider literacy in their patient care. OBJECTIVE: To examine trainee recognition of low literacy as a potential factor in patient adherence and hospital readmission. DESIGN AND PARTICIPANTS: Randomized study of 98 Internal Medicine residents and medical students. Trainees reviewed a case history and completed a questionnaire pertaining to a fictional patient’s hospital readmission. Case version A contained clues to suggest limited patient literacy skills, while version B did not. Responses were reviewed for mention of low literacy and educational strategies recommended for low-literate patients. RESULTS: Few trainees raised the possibility of low patient literacy, even when provided clues (25% in Group A vs 4% in Group B, P=.003). Furthermore, while most trainees listed patient education as an important means of preventing another readmission, only 16% suggested using a strategy recommended for low-literate adults. CONCLUSION: Few trainees recognized low literacy as a potential factor in patient nonadherence and hospital readmission, and few recommended low-literate educational strategies. Medical residents and students may benefit from additional training in the recognition and counseling of low-literate patients. The content of this paper was presented in abstract form at the Society of Hospital Medicine national meeting in April 2003 and at the Society of General Internal Medicine national meeting in May 2003. Dr. Kripalani receives support from a K23 Mentored Patient-Oriented Research Career Development Award (1 K23 HL077597), a Pfizer Health Literacy Scholar Award, and an Heart Association Scientist Development Grant. While conducting the present research, he was supported by the Emory Mentored Clinical Research Scholars Program (NIH/NCRR K12 RR017643).     

The impact of traditional literacy and education on health literacy in adolescents with asthma

Introduction: People with low health literacy have poorer self-management of chronic diseases like asthma. Studies of parent health literacy and education level on the management of children’s chronic illnesses reveal inconclusive results. We hypothesized a correlation between parent and adolescent health literacy in teens with asthma. Methods: Sociodemographic data were obtained; health literacy was assessed on adolescents and parents with three instruments: Rapid Estimate of Adolescent/Adult Literacy in Medicine (REALM), Single Item Literacy Screener (SILS) and Newest Vital Sign (NVS). Agreement between scores was examined by calculating weighted kappa statistics and performing Bowkers test of symmetry. Results: In all, 243 adolescents and 203 parents completed health literacy assessments yielding 198 paired observations. 9th–12th graders, 60.6% female, 72.7% African-American (AA), mean age: 15.3?years (±0.9). Parent education ranged from?<?high school (19.1%) to college graduate (24.0%). Agreement between adolescent and parent scores was poor: REALM (κ_w?=?0.26), SILS (κ_w?=?0.12), and NVS (κ_w?=?0.29) and disagreement did not significantly differ by race. Positive correlations of moderate strength (overall and between racial groups) were found between reading scores and both REALM and NVS scores, and between REALM and NVS scores. Due to the inverse relationship of SILS scores with health literacy level, SILS scores (overall and between racial groups) were weakly and negatively correlated with reading scores, REALM and NVS. Conclusion: Correlation between education level and traditional literacy suggests that these are contributing factors to the health literacy of adolescents with asthma. Correlation between adolescent and caregiver health literacy was not supported.     

Socio-demographic factors and oral health conditions in the elderly: A population-based study

The aim of the present study was to analyze the relationship between oral health conditions and socio-demographic factors in an elderly population from Macaíba/RN (Brazil). A questionnaire was used to characterize the socio-demographic profiles and a clinical examination was performed to assess oral health conditions such as tooth decay, gum disease, use of dental prosthesis, need for dental prosthesis and soft tissue injuries. The technique of random sampling by conglomerates was used, taken from randomly selected census drafts, with a total sample of 441 individuals. The prevalence of edentulism, bleeding and dental calculus was 50.8%, 27.2% and 32%, respectively, excluding all sextants in 59% of the elderly. Data analysis was conducted using the chi-squared test with the level of significance set at 5%. Prior to association tests, the dependant variables were submitted to principal component analysis. Four factors were extracted to represent the oral health conditions of elderly individuals. A statistically significant association was found between the following variables: gender and the presence of a caregiver with gum disease; age, residence area, presence of a caregiver and household density with need for dental prosthesis; and household density with soft tissue injuries. Therefore, precarious oral health conditions were found among the elderly and associations were found between these conditions and the socio-demographic factors, particularly gender, age and residence area. The results obtained demonstrated the need for improved oral health conditions in the elderly. The study of these conditions, allied to socio-demographic factors, is important in terms of both dental care and public policy planning related to these individuals.     

Socio-demographic factors and oral health conditions in the elderly: A population-based study

The aim of the present study was to analyze the relationship between oral health conditions and socio-demographic factors in an elderly population from Macaíba/RN (Brazil). A questionnaire was used to characterize the socio-demographic profiles and a clinical examination was performed to assess oral health conditions such as tooth decay, gum disease, use of dental prosthesis, need for dental prosthesis and soft tissue injuries. The technique of random sampling by conglomerates was used, taken from randomly selected census drafts, with a total sample of 441 individuals. The prevalence of edentulism, bleeding and dental calculus was 50.8%, 27.2% and 32%, respectively, excluding all sextants in 59% of the elderly. Data analysis was conducted using the chi-squared test with the level of significance set at 5%. Prior to association tests, the dependant variables were submitted to principal component analysis. Four factors were extracted to represent the oral health conditions of elderly individuals. A statistically significant association was found between the following variables: gender and the presence of a caregiver with gum disease; age, residence area, presence of a caregiver and household density with need for dental prosthesis; and household density with soft tissue injuries. Therefore, precarious oral health conditions were found among the elderly and associations were found between these conditions and the socio-demographic factors, particularly gender, age and residence area. The results obtained demonstrated the need for improved oral health conditions in the elderly. The study of these conditions, allied to socio-demographic factors, is important in terms of both dental care and public policy planning related to these individuals.     

Association of health literacy and other risk factors with glycemic control among patients with type 2 diabetes in Kuwait: A cross-sectional study

BackgroundPoor health literacy (HL) has received much attention recently as a risk factor for poor health outcomes especially among patients with chronic diseases. The degree to which HL affects health outcomes is unknown among patients with type 2 diabetes mellitus (T2DM) in Kuwait. This study aimed to investigate the association between HL and glycated hemoglobin (HbA1c) among patients with T2DM.Methods356 patients with T2DM were selected from 27 primary care clinics covering the state of Kuwait. HL was measured by the Short Test of Functional Health Literacy in Adults (STOFHLA). Prevalence of uncontrolled HbA1c was estimated and its association with HL was modeled and tested using Poisson regression with log-link function and robust variance-covariance matrix, while adjusting for several confounders.ResultsThe prevalence of uncontrolled HbA1c was 77.8%. Among those with inadequate or marginal HL, about 50.7% have uncontrolled HbA1c. The prevalence of uncontrolled HbA1c among those on diet alone was 36.3% lower compared to those on mixed treatment regimen (APR = 0.637, 95% CI: 0.455–0.891, PV = 0.008). The prevalence of uncontrolled HbA1c among patients on oral hypoglycemic (OH) drugs alone was 22.3% lower compared to those on mixed treatment (OH plus Insulin) regimen (APR = 0.777, 95% CI: 0.697–0.865, PV < 0.001). For every one-year increase in age, there is 1.4% reduction in the prevalence of uncontrolled HbA1c (APR = 0.986, 95% CI: 0.978–0.994, PV < 0.001). For one STOFHLA score increase, there is 0.3% reduction in the prevalence of uncontrolled HbA1c (APR = 0.997, 95% CI: 0.994–1.00, PV = 0.055). Finally, for every year increase since T2DM onset, there is 1.1% increase in the prevalence of uncontrolled HbA1c (APR = 1.011, 95% CI: 1.003–1.019, PV = 0.008).ConclusionsThe prevalence of uncontrolled HbA1c among patients with T2DM in Kuwait is high. Half of T2DM with inadequate or marginal HL have uncontrolled HbA1c. Patients on diet alone or OH alone have lower prevalence of uncontrolled HbA1c compared to those on mixed treatment regimen. Older T2DM patients or those with higher STOFHLA score have lower prevalence of uncontrolled HbA1c, while those with longer T2DM onset have higher prevalence of uncontrolled HbA1c. Future interventions should focus on younger patients, improve HL, and establish better communications between physicians and patients with T2DM for better glycemic control.     

Factors affecting patient safety culture in a university hospital under the universal health insurance system: A cross-sectional study from Japan

We conducted a cross-sectional study of patient safety culture aimed at examining the factors that influence patient safety culture in university hospitals under a universal health insurance system. The Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality was used. The survey was distributed to 1066 hospital employees, and 864 responded. The confirmatory factor analysis showed a good fit of the results to the 12-composites model. The highest positive response rates were for “(1) Teamwork within units” (81%) and “(2) Supervisor/manager expectations and actions promoting patient safety” (80%), and the lowest was for “(10) Staffing” (36%). Hayashi’s quantification theory type 2 revealed that working hours per week had the greatest negative impact on patient safety culture. Under a universal health insurance system, workload and human resources might have a significant impact on the patient safety culture.     

Kidney health for all: Bridging the gap in kidney health education and literacy

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons’ and providers’ education; The World Kidney Day declares 2022 as the year of “Kidney Health for All” to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.     

陕西省居民传染病防治素养现状及影响因素分析

目的了解陕西省城乡居民传染病防治素养现状,分析影响居民传染病防治素养的主要因素。方法采取分层多阶段整群随机抽样的方法,对陕西省15～69岁常住居民进行问卷调查,数据进行标准化和影响因素分析。结果 2017年陕西省居民整体传染病防治素养水平为36.74%,其中城市居民为45.77%,农村居民为31.81%;男性居民为39.88%,女性居民为33.41%;15～24岁组传染病防治素养水平最高,为47.27%,55～64岁组最低为25.60%;随着文化程度的提高,传染病防治素养水平逐渐升高。多因素Logistic回归分析结果显示:居住地、年龄、文化程度是居民传染病防治素养水平的主要影响因素。结论陕西省居民整体传染病防治素养仍处于较低水平,有待于进一步提升。建议针对其薄弱环节,加大对低素养人群健康教育政策的倾斜,有针对性地开展传染病防治宣教和干预。     

The roles of low literacy and social support in predicting the preventability of hospital admission

BACKGROUND: Prior studies found higher hospitalization rates among patients with low literacy, but did not determine the preventability of these admissions or consider other determinants of hospitalization, such as social support. This study evaluated whether low literacy was a predictor for preventability of hospitalization when considered in the context of social support, sociodemographics, health status, and risk behaviors. METHODS: A convenience sample of 400 patients, admitted to general medicine wards in a university-affiliated Veterans Affairs hospital between August 1, 2001 and April 1, 2003, completed a face-to-face interview to assess literacy, sociodemographics, social support, health status, and risk behaviors. Two Board-certified Internists independently assessed preventability of hospitalization and determined the primary preventable cause through blinded medical chart reviews. RESULTS: Neither low literacy ( or =12 people talked to weekly (P<.023). Among nonbinge drinkers with lower social support for medical care, larger social networks were predictive of preventability of hospitalization. Among nonbinge drinkers with higher support for medical care, lower outpatient utilization was predictive of the preventability of hospitalization. CONCLUSIONS: While low literacy was not predictive of admission preventability, the formal assessment of alcohol binge drinking, social support for medical care, social network size, and prior outpatient utilization may enhance our ability to predict the preventability of hospitalizations and develop targeted interventions.     

北京部分社区老年人高尿酸血症患病相关因素的横断面调查

目的:调查北京部分社区老人高尿酸血症(HUA)患病的相关因素。方法:2000年7月至2000年9月在北京宣武区、怀柔区、大兴区3个地区通过分层、整群、随机的抽样方法,抽取2 181名老人进行问卷调查、体格检查及血生化检测,内容包括人口学资料,身高、体质量、血压的测量及空腹血糖、血脂及血尿酸等检测,分析老人HUA患病的相关因素。结果:2 181名老人中共有213例患有HUA,患病率为9.8%。其中男性9.6%,女性9.9%,男女间患病率差异无统计学意义(P>0.05),地区间的患病率排列顺序依次为城区>郊区>山区,差异具有统计学意义(P<0.05);单因素分析显示老年人HUA患病还与体质量指数、三酰甘油、胆固醇,高、低密度脂蛋白胆固醇有关。通过Logistic回归分析显示,HUA患病与年龄、居住地区、体质量指数及血三酰甘油水平有关。结论:控制北京社区老人HUA患病的工作重点为控制体质量及血脂水平,并应加强对山区老人的健康宣教。